The cascade model helps to manage the national scale of the NSBDP, and therefore, builds capacity for successful implementation at various levels. Deworm the World expects to see an increase in partnerships between the various groups in the STH community. For Kenya, Nigeria, Pakistan, and Vietnam we have included an estimate of in-kind contributions from governments. p. 11. District Coordinators hired and managed by non-governmental organizations are more likely to report problems. Deworm the World, comments on a draft of this review, September 12, 2018. So there are specific areas, such as program monitoring, that would likely not have investment at the level we are able to provide. District coordinators ensured timely delivery of training materials, and further distribution of NDD kits at the trainings for all functionaries at school and anganwadi levels. ), Monitors in Delhi in 2013 did not report on either of these observations. Paul Byatta, attachments to email to GiveWell, September 23, 2016, p. 3, In comments on a draft of this review on September 12, 2018, Deworm the World noted: "We have begun to address this issue through methodology changes in our coverage validation surveys. If we decide to fill a funding gap, we either make a grant from our Maximum Impact Fund122 See cell notes in this spreadsheet, cell A6 on sheet [2020] Summary by country and cell A7 on sheets "[2019] Summary by country," "[2018] Summary by country," and "[2017] Summary by country. It is correct that in Jharkhand Aug. 17 it was reported that among children who were present on DD, 100% received deworming tablets. Observing children swallowing is most important when treating for SCH as the tablet does not taste pleasant and there are high chances of children spitting if not observed." The community is now prioritizing STH (in a way similar to how LF became prioritized with the formation of the Global Alliance to Eliminate Lymphatic Filariasis, which has seen significant success). Since 2014, we have helped governments provide over 1.3 billion treatments and continue to support deworming in India, Kenya, Nigeria and Pakistan. Build relationships with key people who manage and lead nonprofit organizations with GuideStar Pro. In practice this is often not in a separate room, but away from the class. "We train monitors to interview children in private by taking them aside for interviews. J-PAL Latin America and the Caribbean is based at the Pontificia Universidad Catlica de Chile. Below, we expand on Deworm the World's role in the programs it supports. STH tablet (ALB) coverage was 99% across observed schools. In collaboration with the Monitoring, Learning & Evaluation (MLE) Strategy and Delivery teams, support our strategic approach to M&E, including potentially engaging on the design of an impact evaluation. Per treatment, these costs are $0.059 ($379,523/6,405,462) and $0.035 ($222,750/6,405,462) respectively, "The cost per treatment in Kenya is higher than in India. GiveWell has rated our Deworm the World Initiative as a top charity every year since 2013.The Life You Can Save, founded by leading moral philosopher Peter Singer, features Evidence Action on its list of best charities in the world.. Based at leading universities around the world, our experts are economists who use randomized evaluations to answer critical questions in the fight against poverty. Because its goal is to treat every person in a community, multiple trips to a single area may be required to ensure total coverage (e.g., if a household member is not at home during the first visit). For example, see DtWI Chhattisgarh 2015 monitoring survey for coverage validation, schools. At the end of the interviews, monitors also sought to determine what proportion of parents would be sending their children for deworming as a proxy for the effectiveness of the sensitization efforts.". Who are the people you serve with your mission? This could have led to a smaller proportion of children being found in the community than anticipated at the planning stage. For example, they ask if the child received a pill and if the child swallowed the pill under supervision.78 In our room for more funding analyses, we typically include reserved funding as funding available to support program activities. ", "The field officers that collect the data in the field are short term hires who come from the counties in which the program is implemented". [] Teachers and principals general salaries are not included because they do not spend additional time on deworming beyond what they are already compensated for by the government for regular classroom teaching." It expects to support program costs in Pakistan, and possibly Indonesia. Ideally, prevalence surveys would be carried out after every third round of treatment immediately prior to the following round. They found that over 50% of school-aged [sic] children had worms, a level at which the World Health Organization (WHO) recommends deworming twice a year, rather than just once a year. We therefore did not apply the WHO guidelines for baseline STH prevalence. ", Deworm the World supports program costs in Cross River, Nigeria and expects to support program costs in future Nigeria states. Thereafter, an initial planning meeting is held with county and sub-county leadership. "We consistently design and support training through an efficient multi-tier cascade approach that is tailored to the local context, ensuring knowledge reaches from the national level all the way to the teachers responsible for administering deworming medication.". There are 6 million children in need of treatment in Kenya and the WHO estimates 241 million children at risk in India. The people, governance practices, and partners that make the organization tick. Other advocacy activities can include discussing: "how deworming can fit into the current policy environment and policy priorities of a government, how such a program can/should be financed, the robust evidence of impact, how a country can best take advantage of WHO drug donations, encourage program champions within government, help establish program governance structures. "Now, state governments have responsibility for testing drugs. See this spreadsheet, sheet "Cross River, Nigeria 2016," cell C11, and Deworm the World External Kenya 2016 Costing Model, sheet "Costing model," cell E9. Three classes were selected randomly from each school by using random number tables. The cadence on which we conduct updates depends largely on how often we grant funding to a top charity120 Extensive conversations with Deworm the World Director Grace Hollister and other Deworm the World and Evidence Action staff since 2012. These procedures were observed to be followed correctly by 86% of teachers observed by field officers. Browse news articles about J-PAL and our affiliated professors, read our press releases and monthly global and research newsletters, and connect with us for media inquiries. ", "We hire master trainers, or train govt staff to be master trainers.". ", "We work closely with the Ministries of Education and Health to design a program with joint ownership, develop operational plans and budgets, coordinate logistics, and provide on-the-ground support to ensure a high quality outcome.". Of this discrepancy, the report states: "The true net enrollment rate may have been much higher than the quoted 54% used to generate the sample for community interviews. It may improve the quality of a deworming program that would have been implemented without Deworm the World (leading to more children dewormed effectively or improved cost-effectiveness). In 2020, CIFF and Dubai Cares provided restricted funding for Deworm the World's support of India's deworming program. How is your organization using feedback from the people you serve? Brett Sedgewick, comments on a draft of this review, October 31, 2019. Grace Hollister, comments on a draft of this review, September 6, 2018. Bihar 2015: Deworming Day and Mop-up Day (N = 247 schools). This is in part because in Kenya Deworm the World is treating for schistosomiasis in addition to STH, and schistosomiasis treatments incur greater costs, including a higher drug cost and more extensive mapping. Note that community-based treatment, such as is typically used for LF, involves enlisting several people to travel from house to house to administer treatment, making it much more time-consuming and costly than school-based programs. We collect feedback from the people we serve at least annually, We take steps to get feedback from marginalized or under-represented people, We aim to collect feedback from as many people we serve as possible, We take steps to ensure people feel comfortable being honest with us, We look for patterns in feedback based on peoples interactions with us (e.g., site, frequency of service, etc. ), We engage the people who provide feedback in looking for ways we can improve in response, We act on the feedback we receive. Pg. Evidence Action's Deworm the World Initiative (evidenceaction.org/#deworm-the-world) advocates for, supports, and evaluates government-run school-based deworming programs. Deworm the World noted that the costs in Kenya are high, partly due to higher quality M&E: "In some ways, Deworm the Worlds program in Kenya has served as a proof of principle for the effectiveness of school-based deworming and is a "gold standard" that is unlikely to be exactly replicated elsewhere. Our goal is to double our impact by 2024, to fulfill our vision of a world where hundreds of millions of people in the poorest places have better opportunities and their lives are measurably improved. 4. For example, see this spreadsheet, sheets "Methods (Nigeria 2019 CV)" and "Methods (Pakistan 2019 CV). We partner with NGOs, governments, donors, multilateral organizations, businesses, and other research centers to conduct randomized evaluations, build research capacity, scale up what works, and promote the use of evidence in decision making. The first of those principles is to put significant weight on our cost-effectiveness estimates. Deworm the World has told us that many places do not have much overlap between different NTDs so school-based deworming programs can provide a cost-effective alternative to community-based treatment. Click on the link in that email Pg. We are global. Typically, when GiveWell donors make a donation to a top charity,124 5. DtWI facilitated drug donations from WHO, provided professional master trainers for training of trainers, developed training materials such as flipcharts, modified training booklet and reporting forms, designed and carried out independent monitoring, and developed adverse event protocols. Independent rigorous research, including by Nobel Laureate Michael Kremer, shows that deworming leads to significant improvements in nutrition, cognition, school participation, and future earnings. Deworm the World supports mass school-based deworming programs, the independent evidence for which we discuss extensively in our intervention report on deworming programs. The prevalences in the table may not be directly comparable to one another. Meanwhile, I worked closely with Birhan Mengistu, an up-and-coming leader seconded from the World Health Organization, and with other Ministry of Health staff. Since then, it has supported deworming programs in India, Kenya, Ethiopia, Nigeria, Vietnam, and Pakistan. Has the board conducted a formal, written self-assessment of its performance within the past three years? Want to see how you can enhance your nonprofit research and unlock more insights? Some of our top charities have a policy of holding funding reserves. Deworm the World spent a total of $8.7 million on deworming programs in 2020, down from $13.9 million in 2019. Deworm the World's advocacy often occurs side-by-side with Deworm the World's technical assistance; once Deworm the World proves that a deworming program can be well-executed, it is easier to interest national governments in funding deworming programs. Our most recent analysis of Deworm the World's room for more funding can be found in this spreadsheet. For example, Deworm the World has assisted in a number of areas in India: Helped government develop operational plans and budgets, Coordinated cross-sectoral partners through the establishment of a State School Health Coordination Committee, bringing together health and education departments and other stakeholders (such as the microfinance partner SKS), Coordinated drug donation made by Feed the Children, Designed a monitoring and evaluation (M&E) system, Created government tableau for community awareness, Conducted a master training session for program, Designed training cascade for the master trainees to train the rest of the implementers, Developed materials and campaigns for community sensitization, "As such, the states themselves have to make the decision to conduct a deworming campaign; DtW can only encourage that decision by showing that it can be done and offering assistance to help implement the program in a robust fashion that involves intensive monitoring of the program. Has the board conducted a formal, written assessment of the chief executive within the past year ? We get this from treatment forms that schools submit back via the reverse cascade. Deworm the World noted that the KEMRI surveys in Kenya are designed for impact assessment, while the surveys in India are designed for mapping. Deworm the World advocates for and supports the implementation of government-run deworming programs for preschool- and school-age children.3 For example, in 2016, Deworm the World supported prevalence surveys in Pakistan because Pakistan had not yet been "mapped" (i.e., prevalence surveys had not yet been conducted in Pakistan), so it was unknown how heavy the worm burden was in Pakistan or where deworming efforts should be focused. We incorporate these into a cost-effectiveness model which is available here. ", The WHO factsheet on STH cites only a single recommended dosage (depending on which drug is used): "The recommended medicines albendazole (400 mg) and mebendazole (500 mg) are effective, inexpensive and easy to administer by non-medical personnel (e.g. The LDA NTD coordinator, PHC coordinator, teachers from the childrens school and the LIE were promptly arrested by the police. These trainers further trained 3032 headmasters and 3032 teachers and 10,500anganwadi workers in groups of 30 participants. Try a low commitment monthly plan today. Learn about the organization's key goals, strategies, capabilities, and progress. Prior to 2020, Deworm the World supported deworming programs in Ethiopia and Vietnam: "The government is fully responsible for program implementation, and these programs leverage thousands of govt personnel from health and education to be able to run." We do this both to ensure consistency across top charities (as not all top charities hold reserves) and to understand the true effect of granting additional funding (i.e. We exclude the portion of Deworm the World's portfolio supported by funding restricted to specific locations. Albendazole dosage is the same for all children aged 2 and above; it is only children aged 1-2 that require a different (half) dose. ", "DtWI would like to do prevalence surveys after every 3 years or so. We focus our review on coverage validation results, which we believe provide the best indication of program impact. What are the causes and consequences of crime, violence, and conflict and how can policy responses improve outcomes for those affected? Deworm the World told us that before it started conversations with the Indian government, the government was not aware that it could obtain albendazole for free from the World Health Organization. India: "absent from most of the country, [schistosomiasis] risk exists only in restricted areas. Additionally, Deworm the World specializes in school-based deworming, which is not the ideal approach in every situation. Working closely with the Africa regional team, drive and launch the expansion of safe water programs into new countries: Working closely with the Accelerator team, lead the identification, testing, and scaling of a portfolio of new safe water interventions: Working closely with the Africa regional team, support the scale-up of high-quality safe water interventions in Kenya, Uganda and Malawi. The correct dosage for albendazole is one tablet per child and the correct age is 2-14 years. The Director will oversee country expansion, new technology development, technical thought leadership, fundraising, and partner management. Therefore in cases such as these, the monitors were trained to intervene and prevent the administration of an additional dose." In Pakistan, all data is collected by third-party firms that are hired and trained by Evidence Actions in-country partner.44. Evidence Action was part of the committee formed by the state government for contextualization of the radio jingle. On cost-effectiveness grounds we believe that it clearly is, as the cost of treatment is cheaper than individual screening. Since 2021, we have helped the government of Liberia improve the quality of prenatal care for women at risk for maternal syphilis. ", In the second round of treatment in Kenya, prevalence surveys were 11% of the total costs and other M&E was 6%. Conversations with the Children's Investment Fund Foundation (CIFF), a funder of Deworm the World. This was a time-bound activity with tight timelines, but was critical to the program implementation. The presence of District Coordinators, combined with the independent monitors hired by Deworm the World that were known to show up unannounced to inspect the program, makes everyone more careful and more likely to implement the program properly because they know that people are paying attention and that they will receive feedback about any mistakes that they make. We believe in bold and urgent action - because poverty doesnt wait, and neither should we. A verification email has been sent to you. For example, in Kenya: "Briefly, systematic and successful deworming days are such that classes are arranged in lines, children wash their hands before deworming, teachers are clearly documenting the names of those dewormed, and there are stations for children who experience any side effects after treatment. We continued serving Ethiopia's TAG into 2020." This understanding is from many conversations with Deworm the World and following Deworm the World's progress over time. We adjust our cost-effectiveness estimate accordingly (more below). They include: We operate in 7 countries across the globe and positively impact the lives of over 280 million people per year.We have helped governments to deliver over 1.3 billion deworming treatments since 2014, at a cost of less than 50 cents per child per treatment.We have installed and regularly maintain over 27,000 chlorine dispensers, ensuring access to safe water for over 4 million people, and averting over 2.2 million cases of childhood diarrhea since 2016.We launched two new programs under the Accelerator: Maternal Syphilis and Iron and Folic Acid Supplementation.When programs that we are testing for their impact and cost-effectiveness dont measure up, we discontinue them - ensuring that our efforts and resources are put towards the most evidence-based and cost-effective interventions. Four powerful questions that require reflection about what really matters - results. Pg. NDD or mop-up day. Appropriately valuing that time spent, and estimating how much time is spent by teachers and others due to the deworming program, is likely the largest source of uncertainty in the cost-per-child-treated calculation for India. Heres how this organization is listening. In early 2013, Innovations for Poverty Action (IPA) announced the formation of Evidence Action to scale cost-effective and evidence-based programs. ", "Note: this [follow-up prevalence survey] strategy is evolving; WHO recommendations are to conduct sentinel site surveys after 5-6 rounds of treatment, and we are moving in that direction. Deworm the World, Jharkhand Independent Monitoring Report 2016. ", "DtWI provided technical expertise across all program components, and served as the primary coordinating body among implementing agencies. Further, one student was selected from each class randomly considering their presence either on the NDD or mop-up day (attendance is verified through attendance register) using random table." If Deworm the World discovered from its advocacy discussions that there were high rates of teacher or student absenteeism, then it might conclude that a school-based deworming program may not work in the country. ", "In Tanzania matters came to a head in places around Morogoro in 2008. Note that if the chosen school is closed on the day of the deworming, they are generally instructed to go to an assigned backup school instead. During school-based coverage validation, monitors randomly select a small sample of students to interview, asking the children questions about their experience on Deworming Day, which are largely the same questions as those asked during household interviews.77 ", Delhi 2015: "Telephone Monitoring and Cross Verification for Process Monitoring: Our tele-callers tracked the status of training, drugs, and IEC material availability at the district, and school/anganwadi through phone calls. How can we increase access to energy, reduce pollution, and mitigate and build resilience to climate change? Conduct scoping activities, including pilots and water point surveys, to adapt the delivery model and prepare for launch. The information we have seen from monitors hired and trained by Deworm the World in India, Kenya, Nigeria, and Pakistan suggests that the programs successfully deliver pills to children, who then swallow them. Design effective delivery models to roll out the interventions. Are mass school-based deworming programs effective when implemented well? @Grace Hollister Conversation June 19th 2013@, Pg 1-4. J-PAL Africa is based at the Southern Africa Labour & Development Research Unit (SALDRU) at the University of Cape Town in South Africa. Our Dispensers for Safe Water program provides safe water access to over 4 million people in rural Kenya, Uganda, and Malawi who are often beyond the reach of existing infrastructure. The training on deworming was integrated with training for the WIFS program to effectively utilize time of participants and trainers and reduce training costs. Which of the following feedback practices does your organization routinely carry out? See, "The majority of direct program costs in India are government funded. For PMCV, we monitor that teachers are aware they should be treating non-enrolled, and they are aware of age categories targeted for non-enrolled. [] Given the pre-existing deworming treatments described above, this prevalence survey cannot be considered a baseline survey of an untreated population, but is rather a survey to assess STH infection rates in a treated population, to determine an optimal treatment strategy.". Deworm the World, comments on a draft of this page, October 2020. The District Coordinators and Deworm the World's tele-callers were valuable because they were able to confirm that schools received the appropriate amount of drugs and that teachers had been trained. The treatment strategy for schistosomiasis also differs from STH because schistosomiasis is more localized (e.g., it is not necessarily ideal to treat an entire sub-county). the disease burden in Deworm the World areas is on average lower than in the study areas, so our expectation is that the impact per child treated is lower in Deworm the World areas. They may also be at risk of social desirability bias: it is possible that children may overreport coverage if they feel pressure from teachers to report positively on their administration of deworming treatment, or if children believe that this is the preferred response of data collectors. Our interpretation of these coverage validation results is informed by their comprehensiveness and the methodology used to collect them. We seek individuals who take an entrepreneurial approach, enjoy tackling hard problems, and have a bias to action and results. We published. in nonprofit board leadership and governance, to create this section. Starting in 2016, we deprioritized publishing notes from our conversations with Deworm the World. In mapping surveys, schools are selected to be representative of a larger geographic area (e.g., they may be selected in part based on which agro-climatic region they are in). Updated numbers can be found here: http://dispenserdata.evidenceaction.org/#/?_k=w0lh7x, Outcome - describing the effects on people or issues. NDD or mop-up day. Who works and leads organizations that serve our diverse communities? This is why, in addition to continuing refinement of our Deworm the World and Dispensers for Safe Water programs, we are working through our Accelerator to select, optimize and scale interventions that can measurably improve the lives of millions of people in the worlds poorest places. Deworm the World notes, "In Kenya, some monitoring is conducted by Evidence Action staff." "Kenyas National School-Based Deworming (NSBD) program carried out only one wave of treatment in its eighth year of deworming (2019-2020) due to the Ministry of Educations decision to close schools as a result of COVID-19." Have the board and senior staff reviewed the conflict-of-interest policy and completed and signed disclosure statements in the past year? Connect with us for all media inquiries and we'll help you find the right person to shed insight on your story. We use qualitative assessments of our top charities to inform our funding recommendations. Madhya Pradesh 2015: In 9.3% of schools, monitors observed children given less than one tablet; in 2.7% of schools, monitors observed children given more than one tablet. Our intuition is that Deworm the Worlds activities increase the quality of the programs it supports, but we are uncertain about this. Register now. The School Health Scheme provided banners to the schools, the distribution of which was integrated in trainings for teachers. (The percentage of schools using less than one pill/bottle per child was not reported.